纳洛酮辅助地佐辛、托烷司琼在甲状腺癌根治术后的镇痛效果及对应激性指标的影响  

The Analgesic Effect of Naloxone-assisted Dizocine and Tropisetron after Radical Surgery for Thyroid Cancer and Its Influence on Stress Indicators

作　　者：任继兵[1] 陈梦琳[1] REN Jibing;CHEN Menglin(Department of Thyroid,Breast,Cardiothoracic Surgery,People's Hospital of Songzi City,Songzi 434200,China;不详)

机构地区：[1]松滋市人民医院甲乳心胸外科,湖北松滋434200

出　　处：《中国医学创新》2025年第8期109-113,共5页Medical Innovation of China

摘　　要：目的:探讨甲状腺癌根治术后采用静脉自控镇痛(PCIA)中加入小剂量纳洛酮的效果及对应激指标的影响。方法:选取2017年1月—2019年12月松滋市人民医院收治的200例拟采取甲状腺癌根治手术治疗的患者,按照随机区组设计方案将患者分入研究组、对照组,每组100例;对照组术后采用托烷司琼+地佐辛实施PCIA,研究组采用托烷司琼+纳洛酮+地佐辛实施PCIA;对比两组手术时间、麻醉时间、术中出血量、术后疼痛视觉模拟评分法(VAS)评分、Bruggrmann舒适度量表(Bruggrmann comfort scale,BCS)评分、镇痛泵按压次数、术后不同时间血浆去甲肾上腺素(NE)、皮质醇(Cor)、空腹血糖及不良反应。结果:两组手术时间、麻醉时间、术中出血量比较,差异均无统计学意义(P>0.05);研究组术后4、12、24、48 h深呼吸或咳嗽状态下VAS评分与术后24 h静息状态下VAS评分均低于对照组,差异均有统计学意义(P<0.05);术后4、12 h,研究组BCS评分均高于对照组,差异均有统计学意义(P<0.05)。术后24 h,研究组NE、Cor水平均低于对照组(P<0.05),两组血糖比较,差异无统计学意义(P>0.05)。研究组的镇痛泵按压次数少于对照组(P<0.05),两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:对甲状腺癌根治术患者采用托烷司琼+纳洛酮+地佐辛实施PCIA,能有效控制患者的疼痛程度、提升患者舒适度、降低手术引起的应激反应程度。Objective:To investigate the effect of low dose Naloxone in patient-controlled intravenous analgesia(PCIA)after radical surgery for thyroid cancer and its influence on stress index.Method:A total of 200 patients scheduled to undergo radical surgery for thyroid cancer in People's Hospital of Songzi City from January 2017 to December 2019 were selected.The patients were divided into a study group and a control group using a randomized block design,with 100 patients in each group.The control group received Tropisetron+Dezocine for postoperative PCIA,while the study group received Tropisetron+Naloxone+Dezocine for PCIA.The operation time,anesthesia time,intraoperative blood loss,postoperative visual analogue scale(VAS)scores,Bruggrmann comfort scale(BCS)scores,number of analgesic pump presses,plasma norepinephrine(NE)levels,cortisol(Cor)levels,fasting blood glucose at different postoperative time points,and adverse reactions were compared between the two groups.Result:There were no statistically significant differences in operation time,anesthesia time,and intraoperative blood loss between the two groups(P>0.05).VAS scores of the study group at 4,12,24 and 48 h after surgery under deep breathing or cough and 24 h after surgery at rest were lower than those of the control group,with statistical significance(P<0.05).At 4 and 12 hours postoperatively,the BCS scores in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).At 24 hours postoperatively,the levels of NE and Cor in the study group were lower than those in the control group(P<0.05),but there was no significant difference in blood glucose between the two groups(P>0.05).The number of analgesic pump presses in the study group was less than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:PCIA with Tropisetron+Naloxone+Dezocine in patients undergoing radical surgery for thyroid cancer can effectively cont

关 键 词：甲状腺癌根治术 静脉自控镇痛 纳洛酮 应激反应 

分 类 号：R61[医药卫生—外科学]